International Alzheimer’s Day is celebrated annually on September 21st, a day established to remind and promote a common global focus on Alzheimer’s disease, a disease that seriously affects the health of humans, especially the elderly. Here we discuss a question that many seniors have asked me, “Will I get Alzheimer’s disease disease?” Alzheimer’s disease is the most common type of dementia in the elderly, and the term – Alzheimer disease (AD) is becoming more and more well known, with some studies suggesting that greater than 40% of seniors over the age of 80 will develop AD.So, what kind of So, what kind of people will get Alzheimer’s disease? What are the risk factors for Alzheimer’s disease (hereinafter referred to as AD)? AD is a disease of the elderly, so the risk of developing AD increases with age, in other words, the longer you live, the more likely you are to get AD. The risk of developing the disease is 5% in people older than 65 years old, and doubles with every 5 years of age, that is, if you reach the age of 70 years old, the risk of developing the disease is 10%, and after the age of 85 years old, the risk is 35% to 85%. After that, the risk will reach 35-40%. But don’t spend your days worrying about getting AD because you’re old. Studies have found that many people in their 80s have excellent cognitive function. The onset of AD is related to many factors other than age. Second, family history To illustrate the problem, the case in the United States. A Mr. John, who presented at age 41, was diagnosed with AD. he was laid off from his job because he could no longer do it well. Symptoms had developed when he was 37 to 38 years old. John has a 42 year old brother who also suffers from AD, their mother died in her 60’s and also had memory loss at that time. Genetic testing at the medical center where he was seen revealed progeria, and a PET (single photon PET scan) of the brain helped to confirm that he had familial AD. It is very worrying that this patient has 3 children, and the specialist has recommended that they all be genetically tested, and that the patient himself has been placed in a special care center. This example reminds us that if we have an immediate family member who has been diagnosed with AD, i.e. if we have a positive family history, we need to pay more attention to our memory and seek medical attention if we have a decline. Women are more likely to suffer from Alzheimer’s disease than men. Overall the ratio of women to men with the disease is 60:40. There may be two reasons for this, one is that life expectancy is shorter for men than for women, which makes the number of elderly women higher than that of men. The second reason is that estrogen has a protective effect on the brain, and this protective effect is compromised by the decline in estrogen levels in post-menopausal women. Some indicators in the blood can indicate the risk of AD, they are: homocysteine, thyroid function, blood sugar, Apo-E genotype, blood lipids, etc. 1. 1. Blood homocysteine Homocysteine can be tested in many hospitals. This indicator will gradually increase with the lack of folic acid level, and hyperhomocysteinemia is closely related to the development of Alzheimer’s disease, vascular dementia, heart disease and stroke. Previous studies have suggested a link between high homocysteine and ischemic stroke and heart disease. However, nearly 30 years of research in Framingham first suggested a link between homocysteine and the development of AD. More recently, a study from Italy found that both high homocysteine and folate deficiency can double the risk of AD. Why does high homocysteine increase the risk of AD? Because it contributes to the production of free radicals and stimulates glutamatergic activity, high levels of homocysteine in the blood can inhibit DNA repair and increase susceptibility to amyloid toxicity, which is the main pathogenetic basis of AD. Homocysteine can be elevated by genetic mutations, aging, vitamin deficiencies, certain diseases, and poor lifestyle habits such as excessive alcohol, coffee, and smoking. Normal homocysteine level is 4~12mmol/L, moderately elevated range is 13~20mmol/L, more than 20 mmol/L is a serious overload. 2, thyroid function Hypothyroidism can also cause memory loss and dementia, hypothyroidism patients blood thyroid stimulating hormone (FSH) rise, free T3, T4 decline. Hypothyroidism can also manifest as depression, difficulty concentrating, chills, facial swelling, hoarseness, swollen joints and muscle weakness. In order to know how well the thyroid is functioning, thyroid function can be tested in any hospital. The normal range of thyroid stimulating hormone (FSH) is 0.4~4.0mIU/L, T3 is 0.1~0.2mcg/dl, and T4 is 4.5~11.2mcg/dl. 3, Blood Sugar Diabetes mellitus, especially type 2 diabetes mellitus, is an important risk factor for AD. That is to say, people with diabetes are more likely to get AD, but the onset of diabetes is more insidious. But it is not difficult to detect diabetes. It can be diagnosed by checking blood sugar, insulin levels, glycosylated hemoglobin and glucose tolerance test. So you need to know the following data: normal fasting blood glucose is 70~100mg/dl, glycated hemoglobin is normally less than 5%, 5%~7.0% is mildly elevated, and more than 7% is significantly elevated. Glucose tolerance test means that after drawing fasting blood glucose, drink double the amount of water containing 75 grams of glucose, and then measure blood glucose every hour for 3 hours. Glucose tolerance test can let us understand the situation of postprandial blood sugar. 4, Apo-E genotype The blood test can determine the most important risk factor – APO-E genotype, apolipoprotein E (apolipoprotein E, ApoE) is in lipid metabolism plays an important role in a class of proteins, ApoE has three main isomers E2, E3, E4, APOE gene is localized in the lipid metabolism, ApoE has three main isomers E2, E3, E4, ApoE gene is localized in the lipid metabolism. , the APOE gene is localized on chromosome 19 and is encoded by three co-dominant alleles, ε2, ε3, and ε4, to produce E2, E3, and E4, respectively, which results in six protein phenotypes: three pure heterozygotes, E2/2, E3/3, and E4/4, and three heterozygotes, E2/3, E2/4, and E3/4. ApoE has been implicated in the onset of Alzheimer’s disease (AD), and ApoE4 increases the According to a study by Dr. Green of Boston University School of Medicine, called REVEAl, the risk of developing AD is 0.8% if the protein phenotype is E2/E2, 3.2% if it is E2/E3, 5.1% if it is E3/E3, and 18% if it is E3/E4, while the risk of developing AD is as high as 67% if the protein phenotype is E4/E4. The risk of developing AD is as high as 67% for individuals with the E4/E4 protein phenotype. In an older person than 65 years old, the risk of developing AD is 13 times higher than in the normal population if the protein phenotype in the blood test is E4/E4. Does having an ε4 gene mean that you will definitely develop AD? It is not the case that people with the causative gene will always get the disease, just that people with the causative gene are more likely to develop AD, and many people with the causative gene remain disease-free until they reach old age. Half of the people with AD do not have the gene. We do not recommend routine testing for the Apo-E genotype, but for people with memory loss, and for people with a clinical diagnosis of mild cognitive impairment who carry the causative gene, 50% will develop AD within 3 years. However, it is best to have these tests and counseling done in specialized hospitals, as sometimes inappropriate explanations can cause panic, which can be detrimental to the patient. It has been found that serum cholesterol rises during the transition to early stages of dementia. Cholesterol can cause cardiovascular disease and has long been known to the general practitioners, so testing the blood lipid level can also give us a clear idea on how to control it. The normal ranges of lipids that we should know are as follows: total cholesterol level <199mg/dl, LDL cholesterol level <100mg/dl and triglycerides <150mg/dl. There are many risk factors for AD, some of which can be changed and some of which cannot. Can you get AD? See if you have any of these risk factors: 1. Risk factors that cannot be intervened include age, family history, influence of genes, and being female; 2. Risk factors that can be intervened include hypertension, hyperlipidemia, heart disease, obesity, cerebrovascular disease, craniocerebral trauma, vitamin deficiencies, diabetes mellitus, and high homocysteine. In order to understand the risk of having AD, we recommend the following blood tests in the hospital: 1. thyroid function; 2. folic acid and vitamin levels; 3. homocysteine; 4. diabetes-related tests; 5. lipid levels; 6. genetic tests are recommended if there is a high suspicion of a hereditary link. With regard to these risk factors, apart from those that cannot be intervened, such as age and gender, there are many factors that can be intervened, and it is possible to prevent and control the occurrence and development of AD. If every elderly person can pay attention to their own risk factors for dementia and intervene effectively, it will be conducive to reducing the overall prevalence of AD, and will be a blessing to every elderly person and even every family.